Vermont plan to fight heroin a stark contrast to N.J.'s

Paul Graham of Rutland, Vt., with his daughter Nakita, whose mother died of a heroin overdose in 2010. “I despise all the people doing heroin,” Graham says.

MILTON, Vt. — On a cold morning last month, as Rusty Beaupre was walking his daughters to the bus stop, he spotted something gleaming on the ground: two syringes on a bed of thawing dirt and pine needles.

Rusty Beaupre of Milton, Vt., at the spot where he found two syringes while walking his daugh¬ters to the bus stop last month. “It was never this bad, growing up,” he says.

The heroin scourge — exemplified by this town of roughly 10,000 people stretched out over 61 square miles just north of Burlington — has spread to all corners of Vermont, so much so that Gov. Peter Shumlin dedicated his entire State of the State address in January to what he called the state’s “full-blown heroin crisis.”

And that unprecedented move — which has attracted an onslaught of national, and even international, attention to this bucolic state with fewer residents than Bergen County — has galvanized public health officials and law enforcement in an ambitious, if still unproven, effort to fix the drug problem from the ground up.

Whether Vermont’s efforts will work, and whether they might be a model for other states, including New Jersey, remains to be seen.

The two states face similar challenges. Both have reported an eightfold increase in demand for opiate-addiction treatment at state-licensed facilities in the past decade, along with a doubling in overdose deaths involving heroin and a rise in crime and gang activity.

But their approaches differ. Vermont has put in place a broad, coordinated law-enforcement and public-health response. New Jersey so far has focused largely on drug arrests and acute emergency care.

Under Governor Christie, the state has expanded drug courts — already considered among the nation’s most ambitious — and inmate addiction care and passed a good Samaritan law protecting those who assist people experiencing a drug overdose. The governor approved a $2.5 million pilot program in 2012 to require court-supervised rehabilitation of low-level offenders who would otherwise serve time in prison. And he made addiction treatment a focal point of his own State of the State address this year, praising current programs and acknowledging the need for more action.

“New Jersey’s approach to reclaiming lives is working,” he said.

Those initiatives pale in comparison to Vermont’s, however. Unlike Vermont, for example, New Jersey has not had a general expansion of treatment programs, and doctors are not required to register with the state’s prescription-monitoring program.

“I had hoped New Jersey would be a leader on the opiate epidemic, the problem with pills,” said Frank Greenagel Jr., who led a state task force on heroin and opiate addiction. “I think we will be a middle-of-the-pack state.”

The two states’ heroin problems are reflections of their population and geography. In New Jersey, a densely packed state with a population approaching 9 million, users ranging from wealthy suburban youth to lifelong addicts seek out heroin in cities. In Paterson, the destination for North Jersey addicts, officials say millions of dollars worth of highly pure, cheap heroin is packaged and sold in open-air markets each week.

Vermont, a rural state with a population of fewer than 630,000, is at least one step removed from the source: Dealers bring backpacks of heroin up the I-87 and I-91 corridors from North Jersey and New York City by bus, rental car and train, moving in and out of rental properties in small cities and towns, and dispense to waiting customers, often at a steep markup — up to $30 a bag, compared with $4 or $5 in Paterson.

“It was never this bad, growing up,” Beaupre said. “It’s coming out of the big cities. They’re coming to Vermont.”

Officials in Vermont say that while the most visible addicts are unemployed residents on public assistance, the epidemic has touched families at every socio-economic level.

“I don’t think there’s a town that would say it’s not a problem,” said Barbara Cimaglio, Vermont’s deputy health commissioner for alcohol- and drug-abuse programs. “But I think in Vermont, where everybody values the quality of life, to see this kind of thing happening, people are saying: ‘We don’t want to become this kind of state. We have to do something about this.’Ÿ”

To be sure, there is increased public awareness of the problem in New Jersey, with communitywide forums and statewide reports. But the lack of sustained engagement has led to complaints from some families and professionals that Christie, a Republican, and the state Legislature, which is dominated by Democrats, have not been more ambitious.

“Racing around and arresting people who are addicted to the drugs — we spend a ton of money, and we’ve almost in some perverse way institutionalized this crisis,” said state Sen. Joseph Vitale, D-Woodbridge, chairman of the Health and Human Services Committee. “It’s exploded. There has got to be a comprehensive approach.”

Different paths

The state budgets in both New Jersey and Vermont set aside increased financing for addiction treatment this year, but the money would be used differently.

Vermont’s $5.6 billion budget increases support for substance abuse and mental-health funding, along with affordable housing, needle exchanges and child care. It also moves to fold addiction programs and primary care into a single health organization.

In his January address, Shumlin said his policies “are designed to reframe the way we solve drug addiction and drug crime in Vermont, attacking it first as the health crisis that it is, while simultaneously retooling our criminal justice system and strengthening law enforcement.”

Christie’s proposed $33 billion budget dedicates $4.5 million in increased funding for the drug courts — partly to expand capacity in addiction-care facilities — and $1 million toward employment services in the program. Community Mental Health and Addiction Services were budgeted a total of $406 million, roughly level with last year.

“The latest thing we’ve seen is politicians saying they really care about the issue, but they’re not putting money into services,” Greenagel said.

“Governor Christie is saying the right things, but it seems like his hands are tied because of the budget,” Greenagel said.